I am currently on Pentasa, Prednisolone and some other supplements to keep me going however my doctor recently suggested that I might have to take some stronger medication to control my condition such as methotrexate.

I came across information on google that this drug is used ot treat Cancer and it has shown to cause cancer for people suffering from Crohn's. I would like to know if people experienced any bad effects on this drugs.

I am weighting if its worth it to just suffer the pain of CD instead of having a risk of having certain type of cancer. CD seems like a better option than cancer.

There are members here that can give more detailed info than myself so I will keep it general.
I'm on Remicade and imuran. I'm at a slightly higher risk for cancer. Having gone through numerous life threatening crohn's complication is a no brainer. (I was dx long before current treatment methods came on the market.

In making you decision please keep the following in mind:

No symptoms does not mean remission. Inflammation can be present and doing damage. This damage can lead to complications requiring surgery. (Blockages, perforations, and fistulas to name a few)

Emergency surgery is far more risky.

Consider the statistical risk of cancer against the statistical risk of complications.

Ds is 11 and on Mtx in addition to humira.
Mtx is used for cancer treatment but at much much higher doses
Mtx has been used for years in rheumatoid arthritis and juvenile arthritis at my her lower doses
Studies for use of Mtx show a lower risk of Mtx plus biologics for cancer than 6-mp/Aza used alone.

I think the risk of developing cancer from taking methotrexate is comparable or lower than azathioprine or 6mp and the risk for those is about 4 in 10,000.

Bear in mind that that risk is tiny and much lower than the risks you take every day getting in a car, crossing the road or riding a bike. And undercontrolled Crohn's comes with risks - we just don't always think about those numbers in the same way as the "scary" cancer risk. If you don't modify the course of Crohn's most patients require surgery and most experience significant effects on their life and health. I don't know where you live (and I don't want to scare you) but there was a report published recently that showed that in the UK 1 in 10 people who need emergency abdominal surgery die within 30 days of surgery. Whilst emergency surgery is one of the more risky situations that Crohnies face we don't always get given statistics about these risks to help us put the risk of side effects from meds in perspective.

I've taken methotrexate and tolerated it well and found it reduced inflammation and reduced damage - both important wins for me and well worth a tiny increase in cancer risk.

Of course only you can make the decision about whether a med is worth taking for you but I think in practice while this may seem like the most important factor now it usually comes down to whether this med works for you and whether you experience side effects.

Compared with so many drugs methotrexate has a long and good safety profile.

How are your symptoms at the moment? And what do your inflammation levels and imaging look like?

I have just got the blood work done today and my appt is in a week time. The last time i went after tapering off preds to 10mg while taking Pentasa, my ESR and CRP rose again but I am not sure if it has to do with inflammation as I got pain in my upper buttocks as I tapered it down. (I made another thread on this question hoping for answers as my doctor wasn't sure whats causing the pain as he tried to examine it bare handed and with x-ray) and thought it might be arthritis.

He mentioned I might have to take some stronger medication which is usually used ot treat cancer. He wasn't specific but from his past prescriptions, he prescribes drugs with minimal side effects first. I am still on preds, pentasa and some supplements.

I hope my ESR and CRP turns out to be normal but I think its unlikely as I am still suffering from the buttock pain (Started 03/2015) and again after tapering off preds (05/2015). Hoping to get a CT scan or MRI to rule out abscess or anything because I am getting irritated from not being able to do any tasks wholeheartedly. I cant even stand for 10mins.

AND ONE IMPORTANT QUESTION: DO YOU GUYS OR ANYONE IN THIS FORUM KNOW IF ANYBODY ENDED UP WITH CANCER FROM THESE DRUGS? I AM EXTREMELY WORRIED AS MY UNCLE PASSED AWAY FROM STOMACH CANCER CAUSED BY ULCER WHICH WAS LEFT UNTREATED FOR A WHILE. I SUSPECT HE HAD CROHNS AFFECTING HIS GUTS AND HE NEVER BOTHERED GOING TO THE DOCTOR.

There are different extra intestinal manifestations(EIMs) of CD that include eyes, skin, joints etc. My son has juvenilespondyloarthropathy(JSpA) related to IBD. He can have SI joint pain that presents in the extreme lower back/butt area. Mr chicken and maya142 also have children with this condition along with their CD. I would recommend a rheumatologist if you are having joint pain.

As far as the cancer risk, a risk also exists for bowel cancer for undertreated or uncontrolled CD. So it is important to take into consideration all risks when considering CD treatment.

Although pentasa may have a low risk profile repeated use of pred can lead to bone damage and other issues. It should'nt be used repetitively or long term if it can be avoided.

If you are worried about the risks of treatment discuss it with your GI. Make a list of your concerns and questions and have him explain them in depth. If you are still not comfortable ask for alternatives. Sadly, most all meds come with rare side effects. Have you looked at the possible side effects of Tylenol? Scary business, yet we don't think twice about taking them for headaches.

A good acronym to present to the doctor is BRAND

B what are the Benefits of this treatment
R what are the Risks of this treatment
A what are the Alternatives to this treatment
N what if we do Nothing
D Decide

Spondyloarthritis (SpA) certainly could be causing butt pain. Does it feel like deep pain? Are you stiff after sitting or sleeping? Does the pain get better with movement? All those are symptoms of inflammatory arthritis and the type of inflammatory arthritis associated with IBD is SpA.

Both my daughters and husband have Ankylosing Spondylitis, which is a form of SpA. They all have pain in their sacroiliac joints and hips. Heat and ice help and so does a TENs unit. My older daughter is on Humira and MTX is and doing very well. Some mild nausea but no other side effects from MTX- no increase in infections or anything like that. My younger one is on Simponi and is not doing quite as well yet, but we'll get there! My husband has been in remission for years - he has completely fused SI joints, so no pain there anymore.

If you think you have some sort of arthritis, a rheumatologist is definitely the person to see. An MRI could show signs of arthritis. Only damage would show up on X-rays, so they may not be as useful if your arthritis is in the early stages.

The meds are certainly scary, but for us, the diseases were much scarier. This is a great presentation about the risks and benefits of various IBD meds: http://programs.rmei.com/CCFA139VL/

There are different extra intestinal manifestations(EIMs) of CD that include eyes, skin, joints etc. My son has juvenilespondyloarthropathy(JSpA) related to IBD. He can have SI joint pain that presents in the extreme lower back/butt area. Mr chicken and maya142 also have children with this condition along with their CD. I would recommend a rheumatologist if you are having joint pain.

As far as the cancer risk, a risk also exists for bowel cancer for undertreated or uncontrolled CD. So it is important to take into consideration all risks when considering CD treatment.

Although pentasa may have a low risk profile repeated use of pred can lead to bone damage and other issues. It should'nt be used repetitively or long term if it can be avoided.

If you are worried about the risks of treatment discuss it with your GI. Make a list of your concerns and questions and have him explain them in depth. If you are still not comfortable ask for alternatives. Sadly, most all meds come with rare side effects. Have you looked at the possible side effects of Tylenol? Scary business, yet we don't think twice about taking them for headaches.

A good acronym to present to the doctor is BRAND

B what are the Benefits of this treatment
R what are the Risks of this treatment
A what are the Alternatives to this treatment
N what if we do Nothing
D Decide

Thanks again Clash for your input! I really appreciate helping me out with my other post as well. Sadly my eyes and arthritis happens to be the problem ever since I was diagnosed with crohns. My left eye is kinda blurry despite getting correct glass prescription. I have high eye pressure and having follow ups for that too as they think I may be a glaucoma suspect . And arthritis too now. I hate having to go to multiple doctors, making sure I don't forget the follow ups.

Despite the fact that my crohns isn't as bad as it is for some people like going to the toilet 10 times a day,I am just irritated. Being 19 and having all these issues, I wonder if I would be able to make it through middle age. I really pray your son does well

Spondyloarthritis (SpA) certainly could be causing butt pain. Does it feel like deep pain? Are you stiff after sitting or sleeping? Does the pain get better with movement? All those are symptoms of inflammatory arthritis and the type of inflammatory arthritis associated with IBD is SpA.

Both my daughters and husband have Ankylosing Spondylitis, which is a form of SpA. They all have pain in their sacroiliac joints and hips. Heat and ice help and so does a TENs unit. My older daughter is on Humira and MTX is and doing very well. Some mild nausea but no other side effects from MTX- no increase in infections or anything like that. My younger one is on Simponi and is not doing quite as well yet, but we'll get there! My husband has been in remission for years - he has completely fused SI joints, so no pain there anymore.

If you think you have some sort of arthritis, a rheumatologist is definitely the person to see. An MRI could show signs of arthritis. Only damage would show up on X-rays, so they may not be as useful if your arthritis is in the early stages.

The meds are certainly scary, but for us, the diseases were much scarier. This is a great presentation about the risks and benefits of various IBD meds: http://programs.rmei.com/CCFA139VL/

Good luck!

Hi Maya!!

I hope your daughters do well. I am extremely confused on how to describe my pain.

Some days, there's mild pain. Some days, it can hurt. I looked for the pain pattern and can't seem to find any. I worked out intensely and I ended up with a 101.6F fever and bad upper left buttock pain. I thought it might be internal abscess that might have burst while working out. Then another day, right after my normal bowel movement, the pain went from barely mild to bad and fever again. I took panadol at both times. Idk what to do :'(

Not sure if you have Crohns or UC. In Crohns Pentasa is a pretty low level drug and many people end up having to escalate treatment.

My daughter was steroid dependent while on Remicae. The doc suggested we add methotrexate. I wasn't ready to take that leap. Not so much for the cancer risk but because of the liver risks and the fact that liver disease runs on both sides of our family. We compromised with a 6-8 week course of Exclusive Enteral Nutrition. EEN is just as effective as steroids with achieving remission and even better in that it can help with mucosal healing. After EEN my daughter remained in remission on Remicade alone for a year.

We did add Methotrexate eventually but that was for her psoriasis and psoriatic arthritis. Methotrexate is helpful with joint pain.

EEN is less effective with adults than pediatric patients and also less successful with UC than Cohns. But worth asking about.

Not sure if you have Crohns or UC. In Crohns Pentasa is a pretty low level drug and many people end up having to escalate treatment.

My daughter was steroid dependent while on Remicade. The doc suggested we add methotrexate. I wasn't ready to take that leap. Not so much for the cancer risk but because of the liver risks and the fact that liver disease runs on both sides of our family. We compromised with a 6-8 week course of Exclusive Enteral Nutrition. EEN is just as effective as steroids with achieving remission and even better in that it can help with mucosal healing. After EEN my daughter remained in remission on Remicade alone for a year.

We did add Methotrexate eventually but that was for her psoriasis and psoriatic arthritis. Methotrexate is helpful with joint pain.

EEN is less effective with adults than pediatric patients and also less successful with UC than Cohns. But worth asking about.